At least a million people die from malaria each year. Some put the estimates as high as 2.7 million. 90% of the deaths are in sub-Saharan Africa. 70% of the deaths are of children under 5. That's equivalent to one child dying of malaria in Africa every 30 seconds. Put another way, 7 jumbo jets full of children disappear because of malaria every day. Malaria deaths are the hardest to count (WHO March 2006)

How do you get malaria?

By being bitten by malaria-carrying mosquitoes. Not all mosquitoes carry malaria. Mosquitoes of the Anopheles genus do, particularly Anopheles gambiae. Malaria is spread by pregnant females that need blood to develop their eggs. The organism that causes malaria is the Plasmodium parasite. There are four types but one type, Plasmodium falciparum, accounts for almost all fatal cases.

Why are children under 5 and pregnant women particularly susceptible to malaria?

Young children take time to build up resistance to malaria. If they get malaria when very young their bodies are often not strong enough to beat it and they may die. However, if a child survives and is bitten repeatedly by infected mosquitoes they gradually build up some resistance to the malaria parasite. The older, stronger child has a much better chance of fighting the disease and not dying.

Where does malaria occur in the world?

Malaria occurs in many parts of the tropical world and in some parts of the subtropics. It is most common between the latitudes of 23.5 degrees north (Tropic of Cancer) and 23.5 degrees south (Tropic of Capricorn). Cases (often seasonal) also occur outside of these latitudes. The burden of malaria in Africa

Is malaria treatable?

Yes, but a malaria infected patient needs to be reached quickly. That's part of the problem. The remote nature of many parts of Africa and other malaria affected regions, the difficulty of recognising that a patient has contracted malaria and not some other disease and the lack of available medicines all contribute to effective treatment not starting quickly enough. The result: many people die. Prevention, for example using bednets, and treatment go hand in hand in combating malaria.

What strategies and actions are used to fight malaria?

No one action will beat malaria. We could distribute as many bednets as we like, but on their own, they are not enough. Prevention and treatment are complimentary tactics used to fight malaria.

Prevention is achieved through: - the use of bednets, preferably treated with an insecticide - removing areas of water where mosquitoes breed - house spraying with insecticide - educating people as to the value of all of these actions to help prevent malaria - and monitoring mosquito populations to understand which insecticides they are sensitive to All these tactics dramatically reduce incidents of malaria.

Treatment includes: - the use of drugs and ensuring the availability of those drugs in a timely fashion, something that is a constant challenge given the remoteness of many parts of Africa. Unfortunately the malaria parasite has become resistant to many drugs, such as chloroquine, which have been used to treat it successfully in the past. Substantial research is needed to find new drugs that can be used in the fight against malaria.

Can malaria be eradicated?

Yes. But certainly not easily, and not for many years in Africa. What’s required is money. Even if not eradicated, malaria can certainly be reduced to dramatically lower levels than exist today. Malaria has already been successfully eradicated or brought under control in some countries.

The Netherlands: In the 1960's malaria was a problem in the The Netherlands. Many people died of malaria between 1960-69. By the early 1970's there were no malaria deaths. This was achieved through spraying of a chemical called DDT. Use of DDT to control malaria is controversial because the insecticide has harmful environmental effects. However, its use is still allowed for malaria control in special circumstances such as a recent epidemic in South Africa. It was possible to eradicate malaria in the Netherlands because the scale of the problem wasn't so large that it required extraordinary amounts of money and the money that was required, whilst substantial, was available.

Vietnam: Here the number of malaria deaths in 1991 was 5,000. In 1999 it was 190. Whilst not eradicated in Vietnam, malaria is under control.

Malaria being brought 'under control' is an important point. In Africa the malaria problem is 'out of control' because it is so widespread and Africa as a continent is poor and does not have the resources to fight it successfully on its own. One of the elements required to help bring it under control, or 'roll back malaria', is money.

We don't know whether it will ever be possible to eradicate malaria from areas where the infection is entrenched such as in tropical Africa. Some believe that advances in technology may allow this. For example, progress is being made on the development of vaccines to prevent malaria but this work is difficult and slow. Others believe that by genetically altering the anopheline mosquito it may be able to create a mosquito that can no longer transmit the infection. However, finding ways that would ensure that this modified mosquito took over from wild mosquitoes across Africa is a daunting task.

These difficulties will not stop researchers trying but with the information we have today we cannot assume such a solution will be found. We have to fight malaria in other ways.

What is the malaria infection cycle?

Mosquitoes breed in water. Different species, including those that can transmit malaria, have different choices of breeding site. For example some anopheline mosquitoes prefer small puddles whilst others prefer flowing streams. They bite an infected person sucking up the malarial parasite and then, when they bite someone else, the parasite is transferred and, if the victim has acquired no immunity over the years, he or she will develop malaria. Most kinds of mosquitoes that can transmit malaria bite mainly between dusk and dawn.

What is the origin of the word 'malaria'?

From the Italian 'mala aria', meaning bad air. It was once thought that ‘bad air’ was the cause of the disease.

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Other questions:

Is it worth fighting malaria?

The very obvious humanitarian answer is yes; it stops people dying. Economically it is also a very sensible thing to do. For every £1m spent on fighting malaria we improve the African Gross Domestic Product (GDP) by £12m. GDP is a measure of wealth. This is because reduced levels of illness and death mean a decreased burden on health systems and increased productivity of a workforce who can generate wealth for their country. Spending £1 to gain £12 is simple, understandable economics. It's a virtuous circle. The more we reduce the impact of malaria, the more the continent of Africa, which currently cannot afford to address the problem on its own, moves closer to being able to fight malaria itself.